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Pharmacological bypass of NAD+ salvage pathway protects neurons from chemotherapy-induced degeneration

Proceedings of the National Academy of Science

October 16, 2018

Liu, Hui-wen

Summary

Axon degeneration, a hallmark of chemotherapy-induced peripheral neuropathy (CIPN), is thought to be caused by a loss of the essential metabolite nicotinamide adenine dinucleotide (NAD+) via the prodegenerative protein SARM1. Some studies challenge this notion, however, and suggest that an aberrant increase in a direct precursor of NAD+, nicotinamide mononucleotide (NMN), rather than loss of NAD+, is responsible. In support of this idea, blocking NMN accumulation in neurons by expressing a bacterial NMN deamidase protected axons from degeneration. We hypothesized that protection could similarly be achieved by reducing NMN production pharmacologically. To achieve this, we took advantage of an alternative pathway for NAD+ generation that goes through the intermediate nicotinic acid mononucleotide (NAMN), rather than NMN. We discovered that nicotinic acid riboside (NAR), a precursor of NAMN, administered in combination with FK866, an inhibitor of the enzyme nicotinamide phosphoribosyltransferase that produces NMN, protected dorsal root ganglion (DRG) axons against vincristine-induced degeneration as well as NMN deamidase. Introducing a different bacterial enzyme that converts NAMN to NMN reversed this protection. Collectively, our data indicate that maintaining NAD+ is not sufficient to protect DRG neurons from vincristine-induced axon degeneration, and elevating NMN, by itself, is not sufficient to cause degeneration. Nonetheless, the combination of FK866 and NAR, which bypasses NMN formation, may provide a therapeutic strategy for neuroprotection. We found that axon degeneration caused by vincristine, a widely used chemotherapeutic agent, could be ameliorated by forcing peripheral neurons to use an NAD+ biosynthetic pathway that bypasses NMN formation...We found that the de novo and Preiss-Handler pathways are not functional in DRGs, and that these neurons relied on the NAM salvage pathway for NAD+ synthesis.

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I am Shelly Albaum, and this is my personal website and blog. All the opinions presented here are my own. Nobody writes here but me. You can read more about me here. Cookies are not required to use this website. Read more about that here. 

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Original work © 2022 by Right of Assembly

No claim to research or any work of others

IMPORTANT DISCLOSURES

1. Health Supplements Are Not Medicines. Health Supplements that raise NAD levels, like nicotinamide riboside or other NAD precursors, are not intended to diagnose, treat, cure, or prevent any disease.

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2. No Medical Advice. I am a lawyer and a journalist, not a doctor, and I offer no medical advice. But I do follow the science, and I can bring to your attention some interesting studies. You can read more about me here. And check with your physician -- your physician can look at this research, too.

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